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Flashcards in Derm Deck (74):
1

treatment for SJS and TEN?

supportive

2

White plaques on red base on the buccal mucosa and inside the oral cavity

Thrush (yeast, candidiasis)

3

Treatment strategies for warts

- cytodestruciton
- immunologic (interferon, cimetidine)

4

treatment for tinea capitis (4 points)

- oral griseofulvin for one month at least
- eat fatty foods
- check CBC, LFTs every 4 weeks on therapy
- NO steroids or antibiotics for kerion

5

Dx for tinea corporis

KOH (culture not necessary)

6

Stevens johnson sydrome (SJS) and toxic epidermal necrosis (TEN) are most often caused by what?

meds: NSAIDS, sulfas, anticonvulsants

7

Main causes of impetigo

- staph aureus, GABHS, MRSA

8

What is the most common cause of scaling scalp in post-pubertal population?

seborrheic dermatitis

9

main 4 causes of cellulitis

1. streptococcus
2. h influenza
3. staph aureus
4. MRSA

10

if child has few-several vesicles that are shallow, punctuate ulcers on the attached gingiva, hard palate, and vermillion border (upper edge of lip) that have lasted for 1-3 weeks, would this be herpes stomatitis or aphthous stomatitis?

herpes stomatitis

11

Treatment for herpes zoster?

oral acyclovir in first 48-72 hours of illness

12

What is the cause of abscess in 75% of cases?

s. aureus mono infection (either MSSA or MRSA)

13

Are topical antibiotics or systemic corticosteroids indicated for eczema?

no

14

SJS has a distinct prodrome similar to

URI

15

Most common cause of tinea capitis

trichophyton tonsurans

16

examples of mild or mild-moderate topical corticosteroids that you might prescribe for a patient with atopic derm

MILD
0.01% hydrocortisone
0.025% triamcinolone

LOWER MID STRENGTH
0.1% hydrocortisone or triamcinalone

17

Avoid what 2 drugs in herpes zoster?

aspirin and ibuprofen

18

> 10 mm bleeding under the skin

bruising

19

Discrete umbilicate papules, contents of papule may extrude with white cheesy material, dermatitis common around the lesion or impetigo

Molluscum contagiosum

20

treatment for classic type Ehlers-Danlos syndrome includes

PT, OT, joint and muscle exercise and stabilization, anti-inflammatories, skin protection, cardiac monitoring, assessment for developmental delay or delayed motor milestones due to hypotonia

21

Treatment for eczema (5 main points)

1. moisturize! (vaseline, cetaphil, crisco, eucerin)
2. mild or mild-moderate topical corticosteroids
3. educate that its a chronic diease
4. bath 3-4x/week and wet wraps
5. can use antipruritics

22

does aphthous stomatitis (canker sores) clear on its own or require treatment? what is the care?

clear on their own

care includes local anesthetics, can include steroids or anti-inflammatories but mostly about numbing and pain relief

23

non-inflammatory stage of tinea capitis lasts how long?

2-8 weeks

24

if child has one-a few ulcers with erythematous halos on the buccal mucosa, floor of mouth, oropharynx, vestibule, or tongue and have lasted 1-2 weeks would this be herpes stomatitis or aphthous stomatitis?

aphthous stomatitis (canker sores)

25

infantile seb derm usually resolves by ___ weeks

12

26

What is the most common symptom of folliculitis?

pruitius

27

diagnosis for tinea capitis (3)

- woods lamp exam
- KOH
- fungal culture (toothbrush)

28

Treatment for thrush

nystatin or diflucan

29

Eczema is often colonized with what?

Staph

30

if diaper dermatitis lasts more than 3 days, may indicate

yeast

31

Most common cause of rash in childhood

viral exanthema

32

Treatment for folliculitis

may not require antibiotics

topical antibiotic therapy is usually sufficient: mupriocin or clindamycin

33

3 main components of urticaria tx:

1. avoid allergen/bath to remove
2. oral antihistamines
3. cool compresses

34

Impetigo often starts as what?

bug bite or skin injury

35

is culture of area helpful with cellulitis?

no

36

If patient present with painful, tender, fluctuant, and erythematous nodule that eventually will have a bustle (may have spontaneous drainage or regional lymphadenopathy) - think?

abscess

37

Treatment for SSSS?

IV antibiotics and supportive measures (ICU)

38

___ involvement would indicate severe SJS or TEN

mucosal (mouth, eyes)

39

If infant presents with yellow greasy scales on scale, red patches on face and flexor surfaces, think

infantile seborrheic dermatitis

40

group of inherited disorders that affect your connective tissue (skin joints blood vessel walls). patients with this genetic disease classically often have overly flexible joints (and often have joint paint or dislocation) or stretchy, fragile skin.

Ehlers-Danlos syndrome

41

- < 4mm spots of bleeding under the skin
- capillary instability
- many causes- infectious most worrisome

petechiae

42

treatment for Idiopathic/immune thrombocytopenic purpura

usually resolves without any treatment

43

A 2 year old presents with pustular, ulcerating lesions on hands and feet in addition to oral lesions. Child is irritable, well-hydrated and afebrile. Most likely dx?

1. Hand foot mouth
2. Aphthous stomatitis
3. Herpetic gingivostomatitis
4. scarlet fever

1. Hand foot mouth

44

treatment for seb derm (2 main points)

2-3x week:
- loosen scales with oil
- gently brush with shampoo containing selenium (dandruff)

- low dose topical steroids

45

If child has grouped vesicles on an erythematous base, coalescent vesicles and erosions, and regional lymphadenopathy, suspect

herpes (HSV)

46

treatment of early lyme disease in children >8 and < 8

>8: doxycycline is recommended agent, 2 mg/kg twice daily (maximum 100 mg dose)

<8 : doxy not recommended, could do amoxicillin 50 mg/kg per day in three divided doses (maximum 500 mg per dose) OR cefuroxime axetil 30 mg/kg per day in two divided doses (maximum 500 mg per dose)

47

for impetigo, child should avoid school/childcare for how many hours?

until on antibiotics for 24 hours

48

staphylococcal scalded skin syndrome (SSSS) is most common in what populations (3)

- neonates
- < 5 years old
- immunocompromised

49

Treatment for abscess if MSSA? if MRSA?

MSSA = cephalexin
MRSA = SMX-TMP or clinda

50

A child has developed honey colored crusts around nose mouth and buttocks that are not getting any better. The best tx would be:

1. cephalexin
2. hydrocortisone
3. mupircoin
4. triple antibiotic

1. cephalexin

51

SJS and TEN may mimic ___ in early course

erythema multiforme

52

treatment for Henoch-Schönlein purpura

steroids

53

this type of purpura affects the small blood vessels of the skin, joints, intestines, and kidneys.
Symptoms include reddish-purple spots on the lower extremities, swollen and sore joints, abdominal pain, or bloody urine.

Henoch-Schönlein purpura

54

If child presents with faint erythematous (almost eczematous) eruption beginning on central face, neck, axilla, groin and then becomes generalized erythema with blisters, plus fever and irritability and positive Nikolsky sign, this would be what?

SSSS

55

Treatment for tinea corporis

- topical therapy first choice (anti fungal like ketoconazole)
- use until lesions are gone + several days-1 week
- treat at least 1 niche beyond the edge of lesion
- don't cover with bandage

56

Treatment for herpes - neonatal? Herpes labialis or whitlow? Herpetic gingivostomatitis?

neonatal - emergency, sepsis workup

Lab or Whitlow: antiviral with outbreak or prophylaxis

Gingivo: first 48 hrs antiviral, symptom management

57

If impetigo is just a few close lesions, what would be the tx?

topical mupirocin or retapamulin

58

If impetigo is anything BUT just a few close lesions, what would be the tx?

systemic treatment - cephalexin or dicloxacillin

59

Treatment for pediculosis (lice)

- permethrin
- retreat in 1 week
- remove nits with comb
- clean environment

60

Diagnosis for HSV

- PCR is highly sensitive and specific
- gold standard = viral culture

61

Treatment for scabies?

- permethrin 5% applied to every part of body under nails etc, leave on for 8-12 hours then rinse off, retreat in 1 week

antihistamines PRN

treat family members

wash linens in hot water

62

Most warts in kids are caused by viruses in what family

HPV

63

A child with boggy nasal mucosa has voluminous clear discharge, dark circles under eyes and itchy erythematous papular red rash behind knees on wrist and AC areas. The diagnosis is:

1. psoriasis
2. atopic derm
3. tinea corporis
4. poison ivy

2. atopic derm

64

4-10mm petechia
common vasculitides

purpura

65

Treatment fr diaper dermatitis? (3 points)

- frequent changes
- NO WIPES -rins with water
- lubricating ointment may prevent overgrowth of yeast

66

Treatment for Molluscum contagiosum

refer to derm

67

Open sores with honey-colored crusts and ooze would indicate

impetigo

68

Ill-defined red plaques that are warm and tender, may have fever and regional lymphadenopathy - think?

cellulitis

69

Treatment for seborrheic derm in the post-puberal population includes what 2 points?

- dandruff shampoo
- mild potency steroid at bedtime only

70

Multiple grouped vesicles on an erythematous base along a dermatome (1 or a few), more of an itching sensation than pain

herpes zoster

71

patch of hair loss in children

tinea capitis

72

HSP is most common before age ____ but can affect anyone.

7

73

papular, scaly, raised patch on skin with a circular border, think

tinea corporis

74

this type of skin finding may occur when the immune system mistakenly attacks platelets. In children, it may follow a viral infection. Symptoms may include easy bruising, bleeding, and pinpoint-sized reddish-purple spots on the lower legs.

Idiopathic/immune thrombocytopenic purpura